Surgical truss



March 23 1926, 1,577,459

G. FOWLER I SURGICAL TRUS S Filed August 5, 1925 m 5 my 14 Patented Mar. 23, 1926.

wire sTarE-s GEORGE rowmna, or LIVERPOOL, ENGLAND.

-'SURGIGAL irlwss.

ppl c ion file'd Augu 1925- jSgr e ll 3- To all whom it may concern:

Be it known that I, ,Gnonen FOWLER, a

subject of the King of Great: Britain, residing in Liverpool, .inxthe county of Lan caster and Kingdom of England, have invented certain new and useful Improvements in Surgical Trusses, of which the following is aspecificati'on.

This invention relates to trusses for the treatment ofhern'i'a, and has for its object to provide a truss which embodies a new principle and conforms more closely'tothe mechanical adaptation of theh'uman hand in its application to the control of inguinal hernia.

It is a Well known fact that it the hand is placedon'the patient, with the thumb on the inguinal ring, after the hernia has been reduced, and the fingers around the "pelvis in a line following thepos'ition'ot a truss spring, the most di'fiicult hernia is easily controlled. It has been my aim in designing my truss to produce a truss in which the pad is applied with the requisi'te'pressure on the hernia in sucha manner as .to simulate the grip of the human hand. In my improved truss the pad is adapted to maintain itself always in the correct position and to exert a constant pressure in the correct direction on the hernia and yet is able to acconnnodate itself easily to the movements of the abdomen of the patient, thereby giving efiicicnt control of the hernia whilepermitting that freedom oi. movement which is-essential. to comfort. Furthermore, in my truss the faults hitherto incidental to trusses, such as pressure around the pelvis, pressure and chafing on bony prominences, and side to side pressure, have been eliminated.

The important features of the truss -according to my invention are that the pad has a hinged connection with the usu-alband or spring that encircles the body a hinge having a double ijoint; and :t'urther, the

spring pressure :on the pa'd is not 'd l from the spring body band, 'as usual, ibut'is produced by a separate and independent spring at the "end er the band acting directly on thepad itself. Further :features "and objects f "the ween w ll ee-@ 3 set forth;

The invention will be more -'p'articularly described with reference to "the accompanying drawings, in which an example ,ot'conicti'on' er t-r'ated.

Frame -1 is a perspective View, on a reduced "scale, of a complete single truss intended torthe-eontrol of right side inguinal hernia. V V I F-igure Q shows the truss in the position o'fiuse. vl

Figure 3-is a front elevation, drawn to an -s"1' ze 'off thepad -plate and the doublejointed hinge. I

Figure 4 is a plan view "of Fig. 3, but with theguard-p late orJshield for the spring fixed to the pad-plate.

:Figures 5 and are respectively an elevation and plan of the compound springused for' applying pad.

Figure 7 is a plan View showing the hernia-sad and its sorin assembled and mounted on the end "of :the spring bodyband. and with the springunder compression as when innse.

Referring to these figures, the hernia-pad 1, is hinged to one end of :the spring bodyband Q'by a hinge having a douhlejoint. and fcomprisingin the construction illustrated a pair of parallel links 3 and. 4, con-- nected together by the hinge-pins 5 and 6 riveted into the ends of the links. The pad is hinged :to the outer hingepin 6 by a metal bar 7, pivotally connected to the pad-plate 8 on its inner side and bert round at one end to form a knuckle 9 embracing the pin "6." 10 is a'plate or bar knuckle jointed at its outer end on the "inner hinge pin 5, and pivotally connected bythe screwpin 11 to the s )ring"body-band 2, so as to be' verti'cally inovable with respect to said band, pin-and-slot eon- Q' by means of the "13', {for the purpose of w ary ng ad'j ufstn'i'eiiit of the "pad wiihen" tt the rues enitlreatient. This adji'l's'tin g" in "is o 1 d to the "he is Z'Qf e known 51y improved truss 1s illus-" pressure to the herniaits spring, such as It, which is adapted to press at two ditlferent points on the outer side of the pad-plate 8, and is secured by the screw 11 through the bar 10 to thespring body-baiu'l 2 so as to be adjustable in a \ertical plaueparallel to that of the bar ll.) but independcntly thereof. At its inner end the spring ll has a curved slot 153 of the some radius asthe slot in the tar 10, and the spring is locked in its adjusted position by the set-screw 123.

The spring ll is a compound spring, in that it is litter ith a supplementary spring blade 1.4: which is riveted or screwed at its outer end to the free. end of the spring 1=l= and extends towards the neck the pad. A spring so made will press against the pad at two points, so as to maintain the parallel action of the pad when in use and apply pressure at the neck as well as towards the centre of the pad. Figs. 5 and 6 show the form of the spring 14: that I refer to use in its unstretched condition, and Fig. 7 shows the spring under compression when the truss is in use. The bearing points of the compound spring n'iight be fitted with anti-friction rollers.

The spring and the double-jointed hinge connection of the pad to the body-band in conjunction constitute essential characteristics of my truss. Upon the spring depends responsibility for the ellect-ire retention of the rupture, and in this respect it rep-resents the pressure exerted by the human hand between the thumb and fingers, whilst the double jointed link-hinge permits inward and outward movement of the pad whilst always maintaining it parallel to the body. It will be seen that the construction and arrangement of the spring is such that it may be adjusted to apply the pressure to various points of the pad. Thes 'iring is removable andfreplaceable by another spring of shorter or longer length, or stronger or weaker, according to requirements, so as to apply the pressure either centrally or towards the end of the pad, and it is also vertically adjustable towards the top or bottom of" the pad, according to the individual requirements of the case. By this means various degrees of pi ure may be applied and the points of application of the pressure varied to suit he needs of the patient. v

The pad 1 which may be of any suit able form or material, is attached by stitching or in other suitable manner to ametal pad plate 8 pivotally connected by a rivet 16 to the hinge bar 7, and has a curved slot 17 in which engages a set-screw 18 screwed into the end of. the bar 7. By these means thepadcanbe angularlyadjusted to a certainextent when fitting to the patient in a plane parallel to f the hinge bar, and such adjustment is independent off iug the screws 21, and is securcr by the The band 2 that encircles the pelvis can be covered with any suitable material, and need not be so springy as usual, as it is to be noted that it is not intended to grip or compress tightly, its function being merely to provide means whereby the appliance may be held in position, and not to exert pressure for the purpose of retaining the rupture. The necessary pressure for this latter purpose,.as already mentioned, given by means of a finely tempered spring working independently and at the end of the band as already described. lt will thus be seen that the band can be treated as a separate entity, and so shaped to the patient that it conforms to his or her particular anatomical structure, and made to lie closely and comfortably round the pelvis without pressure 011 any part.

23 is the usual strap at the opposite end of the spring body-band in a single truss, which strap is secured by engaging one of its holes on the outer end of the screw 1.1.

By. means of the double hinge and the spring the pad, when correctly titted, ap plies a pressure to the hernia in a manner similar to the grip of the hand, and when movement of the abdomen takes place the pad moves correspondingly outwards and inwards while always maintaining itself parallel with the body by the links turning on the inner iinge as a centre. The hinge being doubleacting in oti eet, takes the place of the two thumb joints of the hand. The pad is limited in its movement outwards by the pressure of the spring, but not in wards. By the action of the double hinge the pad is maintained in a parallel position to the inguinal ring, and gives to the wearer that freedom of movement which is so essential to comfort.

It will be noted that the end of the n'ietal spring in the body band bent inwards, as at 24-, and extends over the knuckle of the inner hinge and abuts against. the knuckle of the outer hinge joint. This is for the purpose of forming a stop to prercnt the links flexing inwardsto such an extent as to get-on a dead-centre, or nearly so, andthus prerentingthc free working the double hinge in'the desired manner.

I fdesired, a little play can be allowed in the hinge-joints, so as to permit a slight vertical rocking niovel lont of the pad.

Ill!) body; and a spring connected to the bodyband for applying spring pressure to the rear of the said pad.

2. A surgical truss, comprising a spring body-band; a hernia-pad; a double-jointed hin by which the said pad is hinged to the body-band; means for connecting the two hinge-joints together in such manner as to permit the outer hinge joint to which the pad is hinged to turn about the inner hinge,

oint; means for limiting the inward'movement of the outer hinge-joint; and a spring connected to thehody-hand and adapted to apply pressure to the rear of the hernia-pad.

A surgical truss, comprising a spring body-band; a hernia pad; a pad-plate to which the said pad is attached; a doublejointed hinge comprising a pair of parallel links; means for hinging the pad-plate to the outer hinge-joint; a bar hinged to the other hinge-joint and pivotally connected to the spring body-band; means for adjusting the said bar in a vertical plane on the loodyband; means for limiting the inward flexure of the parallel links on the inner hingejoint; a blade-spring pivotally connected to the said body-band and adapted to apply pressure to the rear of the hernia pad; and meansfor adjusting the blade-spring in a vertical plane on the body-band. Y

4. A surgical truss, comprising a spring body-band; a hernia-pad; a pad-plate to which. the said pad is attached; a doublejointed hinge comprising a pair of parallel links; means for hinging the pad-plate to the outer hinge-joint; a bar hinged to the other hingejoint and pivotally connected to the spring body-band; means for adjusting the said bar in a vertical plane on the body-- hand; means for limiting the inward flexure of the parallel links on the inner hingejoiut; a blade-spring pivotally connected to the body-hand and adapted to apply pressure at two different points on the back of the pad-plate; and means for adjusting said hladespring in a vertical plane on the body band.

5. A. surgical truss, comprising aspring body band; a hernia-pad; a pad-plate to which said pad is attached; a double-jointed hinge comprising a pair of parallel links; a pair of hinge-pins connecting the said Links Wea h r at ends; means in re stricting the inwardmovement of said links; a hinge-bar knuckleointed on the outer hinge-p n and invotally connected to the pad-plate; a pin-and-slot adjustment connection'between said bar and the pad-plate to en s are the angular position of the pad plate on said l1ingebar to be varied; a bar pivotally connected to the spring body-band and kmickle-joint'ed to the other hinge-pin; a pin-and-slot adjusting means for enabling said bar to be adjusted in a vertical plane on the spring body-band; a blade-spring pivotally connected towards one end to said body-band and adapted to apply pressure at its other end to the rearot the pad-platey and means for adjusting said spring'to enable its pressure to be applied at various points between the top and bottom of said pad-plate.

6. A surgical truss, comprising aspring body-band; a hernia-pad, a pad-plate to -wh1ch said pad is attached; a doubleolnted hin e com arisin a aair of aarallel links b o n b l l o n 7 a pair of hinge-pins connecting the said links together at their ends; means tor restricting the inward movement of said links a hin e-bin knuckle-united on the i i outer hinge-pin and pivotally connected to the aad-alate" a nn-and-slot ad ustment u 7 connection between said bar and the padplate to enable theangular position of the pad-plate on said h nge-bar to be varied; a bar plvotally connected to the spring bodyhand and knuckleointed to the other hinge-pin; pin-and-slot adjusting means for enabling said bar to be adjusted: in a ver- Y,

points on the rear of the pad-plate; andv means for enabling the blade-spri1ig to be adjusted in a verticalplane parallel to the said bar and body-band to enable the pres sure of the compound spring to be applied at various points between the top and bottom of the said pad-plate. v

7. A surgical truss, comprising a spring body-band; .a hernia-pad; a pad-plate to which said pad is attached; a double-jointed hinge comprising a pair of parallel links; a pair of hinge-pins connecting the said links together at their ends; means for restricting the inward movement or said links; a hinge-bar knuckle-jointed on the outer hinge-pin and pivotally connected to the pad-plate; a piirand-slot attljustment connection between said ha and the padplate to enable the angular position or the pad-plate on said hingebar to be varied; a bar pivotally connected to the spring bodyband and knuckle-jointed to the other hingepin; pin-and-sl.ot adjusting means for enabling said barv to be adjusted in a vertical plane the spring body-band; a bladespring givotady connected towards one end 'd body-band and adapted to apply presk we at its other end to the rear of the pad-plate; a pin-and-slot connection between the one 012 13116 blade-spring and the bodyband to enable the pressure of said spring to be applied at various points between the top and bottom of said pad-plate; and a guard-plate for covering the soring and the back of the pacLplaie.

In Witness whereof, I have hereunto signed my name this 23 day of July, 1925.

GEORGE FOWLER. 

